As ABC Link Evidence Continues to Mount, Worldwide Cover-up Sinks to New Lows

Joel Brind Ph.D.

It has been famously noted that facts-like the fact
that abortion increases a woman's risk of getting breast cancer -
are stubborn things. One hopes that means that eventually,
the truth always comes out. But along the way, we
also see that necessity - like the political necessity to cover
up the truth of the ABC link - is the mother of increasingly
inventive ways to do just that.

The Abortion-Breast Cancer link was first documented in
the peer-reviewed medical literature in 1957. By 1996, about
two dozen studies from around the world made the link unequivocal
in my view. I and several colleagues published a
comprehensive review and meta-analysis (in the British
Medical Association's epidemiology journal) which documented
a significant, overall breast cancer risk increase of
about 30%.

But peer-reviewed papers from the most prominent sources
of public health information, most notably Oxford University
and the US National Cancer Institute (NCI, an agency
of the US Federal Government), published flawed study after
flawed study claiming to show no risk. So by 2008, the very
idea that abortion could increase a woman's risk of breast
cancer was viewed as heresy worldwide.

The main argument used by ABC-link deniers is variously
called "reporting bias" or "response bias" or "recall bias".
It goes like this: When you construct a standard, retrospective
"case-control" epidemiological study, you identify a
group of women with breast cancer (the "cases") and a similar
sized group of similar women who do not have breast
cancer (the "controls"). Then, via questionnaires and/or interviews,
you find out-among other relevant data pertaining
to medical and reproductive history-who had any abortions
and who did not. If more of the cases have had abortions
compared to controls, this translates to the association
of increased risk with abortion; numerically, a "relative risk"
greater than 1. Moreover, if standard statistical modeling
determines that one can be more than 95% certain that the
association is not due to chance, the result is said to be statistically
significant.

Honest and sincere public health professionals would
surely never dismiss a significant relative risk of 1.3 (as we
reported in 1996 in the aggregate of extant worldwide data),
especially for a life-threatening disease like breast cancer
and a common elective surgical procedure like abortion,
would they?

Enter response bias. Suppose, in the study outlined above,
there really is no difference in the frequency of abortion
among the cases v controls, but the healthy controls are more
likely than the women with breast cancer (cases) to deny
their abortion history. Then it would falsely appear that abortion
was associated with breast cancer, due to response bias:
a bias, or difference in the accuracy of reporting between
the case and control groups.

As plausible as this response bias may seem, credible evievidence
of its existence in ABC link research has never been
demonstrated. In fact, it has been repeatedly proven not to
exist in ABC link studies. That stubborn fact, however, has
not deterred the ABC link deniers from repeatedly citing
the same discredited hypothesis-as if it were fact-to accomplish
their political objective of erasing the ABC link
from the public mind.

Of course, if the ABC link were real, we would expect that
by now-with abortion rates exploding around the world in
recent decades, especially in Asia-we would be witnessing
a growing worldwide breast cancer epidemic. We are.
In late 2013, Dr. Yubei Huang and colleagues published a
systematic review and meta-analysis of 36 studies in mainland
China. They reported an overall 44% increase in breast
cancer risk among women with one or more abortions; up
to an 89% risk increase among women with three or more
abortions.

Moreover, by 2014, no fewer than 13 studies on women
from South Asia (India, Pakistan, Bangladesh, Sri Lanka)
had been published. Every one of them showed increased
risk, with relative risks as high as 10 and 20! These join
other recent studies (from the past 10 years) from elsewhere
in Asia (Iran, Kazakhstan), the Mideast (Egypt, Palestine,
Iraq) and elsewhere (Turkey, Armenia, Mexico) confirming
the ABC link.

Sorry, epidemiologists, response bias does not explain relative
risks of 10 or 20, even if it had any validity at all. And
in the most recent study-yet another one from India, making
the total number of Indian studies 11, all since 2008-is
the strangest yet. The authors of this 2016 study by Nagrani
et al. actually acknowledge that they have observed increased
breast cancer risk with induced abortions, and even that:
"most previous case-control studies have observed a positive
association between induced abortion and breast cancer".
But they are quick to explain, on the basis of severely
flawed studies based on medical records instead of retrospective
interviews or questionnaire, that these results are
"likely to be due to recall bias."

The reason this typical invocation of recall bias is so egregious
in the Nagrani study, is the clear finding of what is
called a "dose effect." This means that the risk increase found
among women with two or more abortions was clearly
greater than that observed among women who had a history
of only one abortion (as had been also documented in 36
Chinese studies). So we are therefore supposed to think that
healthy women who have had one abortion will report it
accurately in a study, but once they have had their second
abortion, they will start lying about their abortions to the
epidemiologists doing the study? In other words, the minimal,
non-significant risk increase (10%) Nagrani et al. reported
to be associated with one abortion is supposed to be
pretty accurate, but the significant, (58-108%) risk increase
associated with two or more abortions can be dismissed as
an artifact caused by recall bias?

So just who are these wizards of smart who believe that
you, dear readers of their study are so stupid and/or so ill
informed as to believe such nonsense? Well let's see: You
would be reading the 15th published, peer-reviewed South
Asian study since 2008 alone that reported data on the ABC
link, all of which previously having reported positive evidence
of the link, and you would not have noticed that not
one of those previous studies was ever mentioned or cited
as a reference!

As I have been studying the ABC link and its cover-up for
over 23 years, I go straight to the by-line. There I see that
one of the co-authors, Preetha Rajamaran, works for the
NCI, the US government agency that has been lying about
the ABC link for over 20 years. That explains everything.